Individual
DIANA P FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
1372 SUMMER ST STE 200, STAMFORD, CT 06905-5361
(000) 000-0000
Mailing address
1026 RICHMOND RD, STATEN ISLAND, NY 10304-2416
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
Other
Enumeration date
05/28/2024
Last updated
01/15/2026
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